When Surgery Is Right
Patients with recurrent ankle sprains, persistent giving-way, and clinical or imaging evidence of ligamentous laxity that has failed at least 3 months of focused bracing and proprioceptive rehabilitation.
The Procedure
Most commonly a modified Brostrom-Gould repair: the stretched ligaments (anterior talofibular ligament, calcaneofibular ligament when needed) are tensioned and reattached to bone, often reinforced with the inferior extensor retinaculum or with internal brace augmentation in selected patients.
Recovery
Walking boot for 2–3 weeks with progressive weight-bearing, transition to a brace at 4–6 weeks, structured rehabilitation, and return to most activities by 3–4 months. Return to high-level court and field sports typically at 5–6 months.